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Iodine Prophylaxis Using Iodized Salt and Risk of Maternal Thyroid Failure in Conditions of Mild Iodine Deficiency

Dipartimento Clinico-Sperimentale di Medicina e Farmacologia (M.M., V.P.L.P., M.C.C., F.M., M.G., M.M., M.A.V., F.T., F.V.), Sezione di Endocrinologia, Dipartimento di Diagnostica di Laboratorio (G.G.), Servizio di Biochimica Clinica, and Dipartimento di Statistica (D.D.D.), University of Messina, 98125 Messina, Italy

Address all correspondence and requests for reprints to: Francesco Vermiglio M.D., Cattedra di Endocrinologia, Policlinico Universitario, Via Consolare Valeria, 98125 Messina, Italy. E-mail: francesco.vermiglio{at}unime.it.

Context: Mild to moderate iodine deficiency during pregnancy can cause transient maternal hypothyroidism and impaired mental development of the progeny. These unfavorable effects are preventable by iodine supplementation. In Europe, however, less than 50% pregnant women receive iodine-containing supplements, thus representing dietary iodized salt the only carrier of iodine for most women in this life stage.

Objective/Design: This longitudinal study is aimed to investigate the effects of long-term iodized salt consumption on maternal thyroid function during gestation.

Participants/Outcome Measures: We prospectively evaluated thyroid function in 100 consecutive thyroperoxidase antibody-negative pregnant women from a mildly iodine-deficient area. Sixty-two women who had regularly used iodized salt for at least 2 yr prior to becoming pregnant and 38 who commenced iodized salt consumption upon becoming pregnant were classified as long-term (LT) and short-term (ST) iodine supplemented, respectively.

Results: Long-term iodized salt consumption resulted in a very low prevalence of maternal thyroid failure (MTF) in LT women. Conversely, short-term iodine prophylaxis does not seem to protect against the risk of MTF, the prevalence of which was almost 6-fold higher in ST than LT women (36.8% vs. 6.4%; ² 14.7, P < 0.0005; relative risk 5.7, 95% confidence interval 2.03–16.08, P < 0.001). The relative risk reduction amounted to 82.5%, this measure indicating the extent to which long-term iodine prophylaxis using iodized salt would reduce the risk of MTF in ST women.

Conclusions: Prolonged iodized salt significantly improves maternal thyroid economy and reduces the risk of maternal thyroid insufficiency during gestation, probably because of a nearly restoring intrathyroidal iodine stores.

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